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Citation
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Joseph BA, Sakran JV, Obaid O, Hosseinpour H, Ditillo M, Anand T, Zakrison TL. Ann. Surg. 2022; ePub(ePub): ePub. |
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Abstract
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OBJECTIVE: Child abuse is a major cause of childhood injury, morbidity, and death. There is a paucity of data on the practice of abuse interventions among this vulnerable population. The aim of our study was to identify the factors associated with interventions for child abuse on a national scale.
METHODS: Retrospective analysis of 2017-2018 ACS-TQIP. All children presenting with suspected/confirmed child abuse and an abuse report filed were included. Patients with missing information regarding abuse interventions were excluded. Outcomes were abuse investigations initiated among those with abuse reports, and change-of-caregiver at discharge among survivors with an investigation initiated. Multivariable regression analyses were performed.
RESULTS: 7,774 child abuse victims with an abuse report were identified. Mean age was 5±5yrs, 4,221(54%) patients were White, 2,297(30%) Black, 1,543(20%) Hispanic, and 5,298(68%) had government-insurance. Most common mechanism was blunt(63%),followed by burns(10%),and penetrating(10%). Median ISS was 5[1-12]. Most common form of abuse was physical(92%), followed by neglect(6%),sexual(3%),and psychological(0.1%). Most common perpetrator of abuse was care provider/teacher(49.5%),followed by member of immediate family(30.5%),or member of the extended/step/foster family(20.0%). 6,377(82%) abuse investigations were initiated for those with abuse reports. Of these, 1,967(33%) resulted in change-of-caregiver. Black children were more likely to have abuse investigated, and Black and Hispanic children were more likely to experience change-of-caregiver after investigations, while privately-insured children were less likely to experience both (Table 3).
CONCLUSION: Significant racial, ethnic, and socioeconomic disparities exist in the nationwide management of child abuse. Further studies are strongly warranted to understand contributing factors and possible strategies to address them. LEVEL OF EVIDENCE: III Therapeutic/Care Management.
Language: en |